Medical Insider – Dr. Cora E. Lim
Increasing autoimmune rheumatic diseases as a consequence of the COVID-19 pandemic: A hypothesis or fact?
(Part 2)
Part 1 of our discussion of this topic said that the consequences of the Coronavirus Disease 2019 (COVID-19) pandemic, caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), will have a lasting effect on the health of the global population. This disease will most likely be viewed as a plague of the 21st century.
We also said that the latest editorial in IJRD has uncovered the association of COVID-19 with Rheumatoid Arthritis (RA) and referred to our study of definite RA after exposure to SARS-CoV-2. (To be continued)
RA is the commonest prototype ARD. The disease spreading may reflect the global autoimmunity trends.
Studies show that the analysis of RA morbidity data revealed a substantial increase in the absolute and relative number of RA patients in some countries.
The increase in RA numbers was registered among dispensary follow-up subjects and those with newly diagnosed diseases.
Back in 2020, there was presentation of a hypothesis of COVID-19 as a potential trigger of RA at the APLAR congress and published a related abstract in IJRD in October 2020.
The same hypothesis, enriched with growing evidence, was discussed in a publication in 2022.
With time passing and accumulating evidence, similar hypotheses of COVID-19-induced RA were tested in large studies with crystallizing a scientific fact of the association.
Indeed, cohort studies in Taiwan, Germany, the UK, and South Korea, published in 2023, confirmed that SARS-CoV-2 infection was associated with increased ARD comorbidity.
Notably, in a German cohort of 641 704 patients with COVID-19, matched with controls, there was a 43% higher likelihood of acquiring a new autoimmune disease within 3–15 months after SARS-CoV-2 infection.
The COVID-19 global vaccination campaign has raised concerns over the scale of adverse outcomes and the likelihood of associated autoimmunity. Importantly, numerous cases of vaccination associated RA have been described, generating new hypotheses.
COVID-19 vaccinations have saved millions of lives and changed the course of the pandemic.
Nonetheless, the same vaccinations coupled with SARS-CoV-2 infections could have a triggering effect among subjects predisposed to autoimmune diseases and those with established ARDs. (To be continued)